Nursing Practice Knowledge

Nursing Discussion #1 Diabetes (either type 1 or type 2) can cause many problems for the patient when the disease is uncontrolled. Please choose one of the problems associated with diabetes and describe what happens to the body to cause the problem. Examine what causes the problem in the patient with diabetes and create a teaching strategy for a patient who is at risk for the problem. Include the types of Insulin in your post, Lantis, Lispro, Regular and Intermediate acting and illustrate how evidence-based practice can improve outcomes.

Justify your answers and cite your references. Type 1 diabetes is an autoimmune disease that destroys the insulin-producing beta cells in the pancreas such that it produces only a little or no insulin. Accounting for 5 to 10% of diabetes in the U.S., the disease occurs primarily in children and young adults. Prior to the discovery of insulin in 1921, everyone with type 1 diabetes died just a few years following diagnosis. People with type 1 diabetes must take insulin daily and the doses must be balanced through activity and types of foods eaten.

Blood glucose levels must be checked frequently and several times each year, a laboratory test known as A1C is conducted to get an average blood glucose level over a two or three-month period. Insulin types include the following: regular (Humulin R, Novolin R), NPH insulin (Novolin N, Humulin N), Lente insulin Ultralente insulin, Novolog (Insulin aspart) Humalog (Insulin Lispro), Apidra (insulin glulisine recombinant), Lantus (insulin glargine recombinant), Levemir (insulin detemir recombinant), Insulin comes in three different forms-vials, prefilled syringes, and cartridges.

The cartridges are to be used in a pen-like device that simplifies injection. Regular human insulin (Novolin R, Humulin R) is available in vials, cartridges, and prefilled syringes. A symptom of uncontrolled diabetes is blurred vision. When a person with diabetes experiences prolonged high blood glucose levels, the lens of eye can absorb glucose so much that its shape is changed and this causes changes in vision. Control of blood glucose levels through proper levels of insulin prevents damage from occurring. References National Diabetes Information Clearinghouse (NDIC). U.S.

Department of Health and Human Services. Retrieved http://www.diabetes.niddk.nih.gov/dm/pubs/overview/ ____. (2002, September). A Scientific Progress Report on The Diabetes Research Working Group's Strategic Plan. Strategic Plans and Reports. National Institutes of Diabetes and Digestive and Kidney Diseases. Retrieved http://www.niddk.nih.gov/about-niddk/strategic-plans-reports/Pages/conquering-diabetes-highlights-program-efforts-research-advances-opportunities.aspx Discussion #2 The Centers for Disease Control and Prevention (CDC) has put out some important information on drug resistance. Please visit http://www.cdc.gov/getsmart / and view some of the resources available there.

Go to the "Get Smart" campaign materials. Share with your peers the information that you learned.

Do you think it is a good resource for the general public? Why or why not? Have you ever been prescribed an antibiotic for a condition that may not have needed one? Was the treatment effective? In hindsight, would you have been disappointed if you hadn't gotten a prescription after making a trip to the prescriber? Why or why not? How do you see the effectiveness of antibiotic therapy changing for future generations? Justify your answers and cite your references.

I do think this is a good resource for the general public; although the materials are primarily geared for healthcare providers' use, the campaign materials, are intended to be shared with patients and the public. One of the strong themes running through the materials deals with the misunderstanding that people have about how antibiotics should be prescribed and what types of infections they effectively treat. Patients typically request antibiotics for viral infections without realizing that the drugs will not be effective.

The campaign materials also provide tips about how to appropriately treat common infections without antibiotics, which can be quite helpful for people who are not adequately informed. I have never been prescribed an antibiotic for a condition that should not be treated with antibiotics. However, I have known this to happen to other people -- generally with small children for whom a secondary bacterial infection -- such as an ear infection following a cold -- could be a possibility.

I am not confident that cultures were run before the antibiotic was prescribed. It is a significant concern for future generations that antibiotics are being prescribed for conditions that do not warrant the medication. Antibiotic-resistant microbes are already evident in the environment, and without a concerted effort to preclude these inappropriate prescriptions of antibiotics, there are likely to be global outbreaks of disease for which no treatments are available. References Get Smart: Know When Antibiotics Work. Center for Disease Control and Prevention.

Retrieved http://www.cdc.gov/getsmart/specific-groups/hcp/index.html Centers for Disease Control and Prevention. Active Bacterial Core Surveillance Report, Emerging Infections Program Network, Methicillin-Resistant Staphylococcus aureus. (2011). Retreived http://www.cdc.gov/abcs/reports-findings/survreports/mrsa11.pdf Discussion #3 Glucocorticoids are given via inhalation, PO, and IV for various situations pertaining to asthma. Describe how each of these forms may cause problems in the pediatric patient.

How may the drug montelukast be different? What do you tell parents of children with asthma? Are there alternatives to these drugs? Use the internet and your text to discuss the "Step wise" treatment of asthma. Justify your answers and cite your references. Glucocorticoids do not act immediately and so they must not be relied upon to treat acute asthma exacerbations or as maintenance for pediatric patients who experience severe asthma attacks.

Once control over severe persistent asthma occurs, it is preferable to address maintenance with high dosages of inhaled corticosteroids over oral glucocorticoids since corticosteroids are associated with fewer systemic effects. Montelukast is used to treat the shortness of breath and wheezing caused by asthma.